Conditions We Treat: Cerebral Palsy

Cerebral palsy (CP) is caused by a brain injury and affects movement and muscle tone in different parts of the body, depending on the location of damage in the brain. Almost half of children living with cerebral palsy develop hypertonia (excessive muscle tension) or spasticity (excessive muscle tension with increased tendon reflexes). Currently there is not a cure for cerebral palsy, but experts can help address symptoms.

Cerebral Palsy: Why Choose Johns Hopkins?

At Johns Hopkins Pediatric Neurosurgery, a multidisciplinary team assesses your child and recommends surgical and other treatments for optimal relief and function.

If surgery is recommended for your child’s cerebral palsy, you will find a dedicated and compassionate environment for healing at the Johns Hopkins Children’s Center, which offers comprehensive care and support for the entire family as well as the individual child.

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Selective Dorsal Rhizotomy: FAQ | Dr. Shenandoah "Dody" Robinson

Johns Hopkins pediatric neurosurgeon Shenandoah “Dody” Robinson answers frequently asked questions about selective dorsal rhizotomy for patients with spasticity conditions, such as cerebral palsy. Dr. Robinson discusses the best candidates for this procedure, the best time to consider surgery and long-term results.

Cerebral Palsy: Treatments

Baclofen — Baclofen is a muscle relaxant. It can be absorbed into the bloodstream when taken orally, or it can be inserted directly into the cerebrospinal fluid (CSF) through a baclofen pump. This method is particularly effective because it delivers the drug directly to the target site in the spinal cord. The baclofen pump itself is a small titanium disk, about one inch thick and three inches wide. It contains a refillable reservoir for the drug and a computer chip that regulates the dose. An alarm sounds when the device needs to be refilled, when the battery is running low or if the pump is not delivering the drug. The pump should be refilled and medication adjusted every two to three months.

Therapeutic electrical stimulation (TES) — TES is a type of electrical stimulation used at night while patients are sleeping. It increases blood flow to weakened muscles to allow the body to deliver more growth factors and nutrients to repair damaged tissue. The treatment usually lasts between three and six months, and physical therapy takes place at the same time to increase your child's muscle strength.

Selective Dorsal Rhizotomy (SDR) — Selective dorsal rhizotomy involves cutting some of the sensory nerve fibers that come from the muscles and enter the spinal cord. The surgeon makes a five- to six-inch incision along the center of the lower back just above the waist in order to expose the nerves and locate the abnormal portions of nerve fiber that need to be treated. The procedure can reduce spasms, but does require a commitment to intensive physical therapy following treatment.

Cerebral Palsy Specialists

At Johns Hopkins, your child will benefit from the combined insights of neurosurgeons, neurologists, occupational therapists and others, who review your child’s unique needs and develop an individualized treatment plan.

Journee, age 4, was born with cerebral palsy. She and her mother traveled from Boston to meet pediatric orthopaedic surgeon Ranjit Varghese and neurosurgeon Shenandoah Robinson. Journee's surgeons developed a treatment plan with the rehabilitation team at the Kennedy Krieger Institute to get her standing and walking for the first time.